AB1047 EFFECT OF THERAPY ON SUBCLINICAL CAROTID ATHEROSCLEROSIS IN PATIENTS WITH CALCIUM PYROPHOSPHATE DEPOSITION DISEASE (PILOT STUDY)
Authors: M. Eliseev, O. Sheliabina, M. Chikina, E. Markelova, I. Kirillova
Journal: Annals of the Rheumatic Diseases (2022)

Background Supposedly, anti-inflammatory therapy in calcium pyrophosphate deposition disease (CPPD) pts may reduce the progression of atherosclerosis. Objectives Assessment of the dynamics of atherosclerosis development based on changes of carotid artery intima-media thickness (caIMT) in pts with CPPD receiving anti-inflammatory therapy (colchicine, methotrexate, hydroxychloroquine). Methods The prospective study included 26 pts aged ≥18 years with a crystal-verified diagnosis of CPPD and osteoarthritis (OA). Exclusion criteria were age &gt;65 years, presence of cardiovascular disease, carotid artery (CA) atherosclerosis according to ultrasound results, high or very high SCORE (Systematic Coronary Risk Evaluation) index. The examination included anthropometric parameters, information about the affected joints and the time of onset of symptoms. Laboratory tests included determination of the following in blood serum: hs-CRP, lipid levels; SCORE index was calculated for all pts; CA Doppler ultrasonography (DU) was performed using the Esaote MyLab Twice ultrasound system (Italy). The manifestation of subclinical atherosclerosis was diagnosed in case of caIMT increase &gt;0.9 mm. The criteria for the presence of an atherosclerotic plaque in the CA was a local caIMT increase of more than 50% compared to the surrounding areas or an caIMT increase &gt;1.3 mm. CaIMT was measured at the first visit, then, pts with CPPD were administered methotrexate 15 mg/week or hydroxychloroquine 200 mg/day or colchicine 0.5 mg twice daily. Pts could take NSAIDs to relieve pain. After 26-28 weeks, a second examination was carried out. Statistica 12.0 package was used for statistical data processing. Results The baseline values of caIMT in pts with CPPD and OA did not differ. 22 pts with CPPD and 19 with OA were examined in dynamics. Baseline caIMT &gt;0.9 mm was detected in 11 of 22 (50%) pts with CPPD and in 8 of 19 (42%) pts with OA (p=0.39). CaIMT &gt;0.9 mm was associated with an increase in hs-CRP levels &gt;0.2 mg/l in 8 pts with CPPD. 9 of 19 (47%) pts with OA demonstrated an increase in caIMT averages, the values in other pts remained unchanged. By the end of the study, 14 of 22 (64%) pts with CPPD had a decrease in the average values of caIMT, in 2 (9%) pts - an increase, in 6 pts the average values of caIMT did not change. 7 of 11 pts with CPPD showed normalization of caIMT, 5 of them (45.5%) had a decrease in serum hs-CRP &lt;2 mg/l. A decrease in the number of pts with CPPD and caIMT &gt;0.9 mm from 11 (42%) to 4 (18%) pts was found. At the same time, in 8 pts with CPPD the serum hs-CRP level significantly decreased: baseline 6.02 [0.69; 6.4] mg/l vs at the end of study period 1.71 [0.78; 2.25] mg/l, p=0.043. Pts with OA demonstrated the constant level: baseline 2.13[0.22; 2.8] mg/l vs at th end of study period 3.06 [0.39; 6.38] mg/l, р=0.627. A decrease in mean values of caIMT was noted in 5 of 6 (83%) pts took hydroxychloroquine, in 6 of 9 (67%) pts took colchicine, in 4 of 7 (57%) pts – methotrexate. Conclusion Therapy with colchicine, methotrexate and hydroxychloroquine in pts with CPPD leads to regression of early signs of atherosclerosis. This result can be achieved by suppressing chronic inflammation. Disclosure of Interests Maxim Eliseev Speakers bureau: Berlin Chemie Menarini Group, Sobi, EGIS, CSC, MosFarma, Alium Group, Olga Sheliabina Speakers bureau: Berlin Chemie Menarini Group, Maria Chikina: None declared, Eugenia Markelova: None declared, Irina Kirillova: None declared